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Individual

DR. GLADIMIRO DAVILA MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
CALLE JOSE C. BARBOSA, # 68, LAS PIEDRAS, PR 00771
(787) 733-5588
(787) 733-5588
Mailing address
P.O. BOX 1043, LAS PIEDRAS, PR 00771-1043
(787) 733-5588
(787) 733-5588

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7078
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0028612
PTAN MEDICARE
PR
01
0028612 A
MEDICARE PTAN
PR
01
0085466A
HATO TEJAS, PSC , PTAN
PR
01
7078
PUERTO RICO MEDICINE DOCTOR LICENCE
PR
01
C79765Z
IMAGING & RADIOLOGY ADVOCTES, PSC, PTAN
PR
01
DM-06294-3
AMSSCA
PR
Enumeration date
06/07/2006
Last updated
03/07/2023
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